ACPC载药核心块状同种异体骨修复长段感染性骨缺损研究  

Research on the repair of infected long bone defects by using allogeneic bone blocks with ACPC drug-loaded core

作　　者：芦北极[1] 孙俊英[1] 王云清[1] 魏学杰[1] 魏东[1] 

机构地区：[1]徐州医学院第二附属医院骨一科,江苏徐州215006

出　　处：《现代预防医学》2012年第8期2011-2012,2017,共3页Modern Preventive Medicine

摘　　要：目的探讨自固化磷酸钙人工骨(ACPC)载药核心块状同种异体骨创伤性骨髓炎骨缺损的临床意义。方法应用ACPC载药核心块状同种异体骨治疗27例创伤性骨髓炎患者,男21例,女6例,平均年龄为45.2岁,骨髓炎病程为10～18个月。骨缺损范围6～124cm2。观察:患者手术前后的全身及局部组织反应、ESR及CRP、X线摄片和CT扫描。随访时间为12～24个月,平均18.5个月。结果全部患者未见明显全身反应,31例局部软组织愈合好,窦道消除,X线显示ACPC与骨髓炎清除区局部骨质直接愈合,CT示界面处未见间隙存在,基本恢复骨缺损处的解剖形状。Ⅰ期治愈率为86.1%。另5例需要第二次清创、ACPC载药核心块状同种异体骨植入填充的手术,获治愈。结论 ACPC载药核心块状同种异体骨创伤性骨髓炎骨缺损具有治疗彻底、骨缺损修复好、能较好恢复负重肢体功能的优点。OBJECTIVE To investigate the clinical role of allogeneic bone blocks with Autosolidification Calcium Phosphate Cement（ACPC）drug-loaded core in treating traumatic osteomyelitis.METHODS There were 21 males and 6 females traumatic osteomyelitis patients treated with allogeneic bone of ACPC drug-loaded core.The average age was 45.2 years,and the duration of osteomyelitis was ranged from 10 to 18 months.The bone defects range was 5-125cm2.Observation：before and after surgery,the patients were tested with systemic and local tissue reaction test,ESR and CRP,X-ray and CT scan.The follow up was 24 months with an average of 18.5 months.RESULTS No obvious systemic reactions were found in all patients.There were 31 patients whose local soft-tissue healed well and the sinuses were eliminated;The X ray results showed direct bone healing at the osteomyelitis clearing region treated with ACPC.The CT results showed no gap exists at the interface and the anatomical shape at the region with bone defects was basically restored.The cure rate of the first course of treatment was 86.1% and 5 patients were required for a second debridement and ACPC allogeneic bone implant surgery in order to be cured.CONCLUSION There is a thorough treatment of bone defects when apply allogeneic bone blocks with ACPC drug-loaded core in treating traumatic osteomyelitis.The repair of bone defects and the recovery of limb function of weight-bearing are good.

关 键 词：创伤性骨髓炎骨缺损 同种异体骨 自固化磷酸钙人工骨 

分 类 号：R681[医药卫生—骨科学]